Rhonda Stokley, DDS
• State Public Health Dental Director
• Manager, Oral Health Surveillance Program, Department of State Health Services
• Interim Section Director, Public Health Screening and Services Coordination
12/5/2017 2
Learning Objectives
Attendees will:Understand the State of Texas has an oral health program whose role is to conduct oral health surveillance and other dental public health activities throughout the state.
12/5/2017 3
Learning Objectives
Attendees will:Learn about some of the program’s oral health surveillance activities and why they are an important part of public health.
12/5/2017 4
Learning Objectives
Attendees will:Understand the goals of the Healthy Texas Smiles for Moms and Babies project.
12/5/2017 5
Overview of OHSP
• 5 Regional Dental TeamsTeam = 1 dentist + 1 hygienist
• 6 Central Office team members
• Surveillance projects and public health initiatives
12/5/2017 6
Rev 11.1.2017
HSR 1 and 2-LubbockRick Howard, DDS6302 Iola AveLubbock, TX 79424806-783-6480806-783-6455 fax Rene Comey, RDH806-783-6477
HSR 3, 4 and 5N-TylerKimberly Melendez, DDS2521 West Front StreetTyler, TX 75702 903-533-5202903-593-4187 fax Teresa Hubbell, RDH903-533-5278
HSR 8 and 11-San AntonioMatt Williams, DMD 7430 Louis Pasteur DriveSan Antonio, TX 78229210-949-2124210-949-2010 faxCynthia King, RDH210-949-2106
ORAL HEALTH PROGRAM
REGIONAL STAFF
HSR 5S, 6 and 7-HoustonAnita Albert, DDS5425 Polk Avenue, Suite JHouston, TX 77023-1497713-767-3401713-767-3408 faxDiana Beeman, RDH713-767-3402
* HSR= Health Service Region
HSR 9 and 10-MidlandShenice Williams, DDSSondra McDonald, RDH2301 N. Big Spring, Suite 300Midland, TX 79705 432-571-4157432-684-3932 fax
OHSP Regional Teams
• Portable dental equipment
• Limited oral evaluations, fluoride varnish applications, sealants, oral health education
• Piloting silver diamine fluoride this fall
12/5/2017 8
OHSP Regional Teams
• Oral health surveillance and prevention clinics
• Community events
• Collaborations with dental hygiene programs, Project Saving Smiles, Operation Lone Star, East Texas Medical Dental Outreach, etc.
12/5/2017 9
Prevention Clinics
In FY 17:
• OHSP-led activities resulted in 6,125 children receiving a limited oral evaluation (LOE), 790 children receiving sealants on 4,944 teeth
• OHSP contributed to other activities that resulted in 9,409 children receiving LOEs and 30,602 sealed teeth
12/5/2017 10
Surveillance
• Basic Screening Survey (BSS) of 3rd grade and Head Start in TX
o Since 2008
o Every 5 years
o 3rd grade BSS being conducted during the 2017-18 school year
o Changing from Head Start to Kindergarten in 2018-2019 school year
• National Oral Health Surveillance System (NOHSS)
• Texas Oral Health Surveillance System (TOHSS)
12/5/2017 11
BSS Study Design• Target sample size to
reliably estimate a 95% confidence interval (CI)
• Probability Proportional to Size (PPS)
• Four strata:o Urban-bordero Rural-bordero Urban-non-bordero Rural-non-border
• Calibrated dentists
12/5/2017 12
Conducting Surveillance
• Portable dental equipment
• Consent forms
• Limited oral evaluation:oPast treatmentoUntreated cariesoUrgent dental care neededoEarly dental care neededoSealant prevalence (for 3rd
grade)
• Results form for parents
12/5/2017 13
BSS Data and Trends
12/5/2017
Source: Basic Screening Survey (BSS) SFY 2008 and 2012Prepared by Office of Program Decision Support (OPDS), FCHS, DSHSNovember 3, 2014 (ds) 14
HP 2020, 25.9
SY 08-09, 42.7
SY 12-13, 25.9
0
10
20
30
40
50
60
HP 2020 SY 08-09 SY 12-13
PERCEN
T
TEXAS COMPARED TO HP 2020 GOAL
Texas 3rd Grade BSS: Untreated Caries
BSS Data and Trends
HP 2020 Goal, 49
TX 2012-13,
68.1
0
10
20
30
40
50
60
70
80
HP 2020 Goal TX 2012-13
PERCEN
T
TEXAS COMPARED TO HP 2020 GOAL
Texas 3rd Grade BSS: Caries Experience
12/5/2017
Source: Basic Screening Survey (BSS) SFY 2012Prepared by Office of Program Decision Support (OPDS), FCHS, DSHS March 2017 15
BSS Data and Trends
HP 2020, 28.1
TX 08-09, 34.4
TX 12-13, 51.0
0
10
20
30
40
50
60
HP 2020 TX 08-09 TX 12-13
PERCEN
T
TEXAS COMPARED TO HP 2020
Texas 3rd Grade BSS: Sealant Prevalence
Source: Basic Screening Survey (BSS) SFY 2008 and 2012Prepared by Office of Program Decision Support (OPDS), FCHS, DSHSNovember 3, 2014 (ds)
16
Healthy Texas Smiles for Moms and Babies
12/5/2017
This project supported by the Health Resources and Services Administration (HRSA) of the U. S. Department of Health and Human Services (HHS) under grant H47MC29820 Children’s Oral
Healthcare Access Program. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsement be inferred
by HRSA or the U.S. Government
17
Healthy Texas Smiles for Moms and Babies
3-year Health Resources and Services Administration (HRSA) grant; June 2016-May 2019
Goal:
Increase the number of at-risk pregnant women and infants who visit a dentist for dental care.
12/5/2017 18
Healthy Texas Smiles for Moms and Babies
35.3% of Texas mothers with a recent birth who had their teeth cleaned during a recent pregnancy.
12/5/2017Texas PRAMS 2012-2014 combined. Data prepared by the
DSHS Office of Program Decision Support, March 201719
Healthy Texas Smiles for Moms and Babies
Home visiting programs: to improve home visitors’ understanding of oral health and promote the addition of oral health metrics to their data collection.
Survey dentists to acquire baseline data on Texas dentists’ knowledge and attitudes regarding dental care for pregnant women and infants.
Develop and promote Texas Perinatal, Infant, and Early Childhood Oral Health Guidelines
12/5/2017 20
HTSMB Progress To Date
Trained four Nurse Family Partnership programs; two in San Antonio and one each in Edinburg and Wichita Falls. Impact: ~480 current NFP families and future clients.
Survey of dentists’ knowledge, attitudes and behaviors on dental care for pregnant women and infants will be distributed by mid-December.
Texas Perinatal, Infant, and Early Childhood Oral Health Guidelines are drafted and undergoing internal review. Anticipated publishing date is May 31, 2018.
12/5/2017 21
Conclusion
• Oral health surveillanceBasic Screening Survey
Other surveys
• Healthy Texas Smiles for Moms and Babies
12/5/2017 22